1. Enrollment Application For Dr. D.D. Brown Christian Academy of Hope
2. Dr. D.D. Brown Christian Christian Academy Academy of Hope of Private Hope School Mission Mission Statement Statement- Preparing - "To Respect The Children Individual's for the Kingdom Need of of God Children, Spiritually, Foster And Environment That Is Caring And Academically, and Emotionally. Our mission is to provide an excellent education program Supportive; Emphasize The Spiritual, Social, Emotional, Physical, And Intellectual that enables our students to develop intelligence, self-esteem and security in a Christian Development learning Of Each Child." PARENT PLEDGE AGREEMENT Dr. D.D. Brown Christian Academy of Hope is dedicated and committed parents pledge the following: 1. We will pray daily and earnestly for Dr. D.D. Brown Christian Academy of Hope. 2. We will support the administration and the policies and procedures set forth in the Parent Student Handbook. 3. We understand and agree that the atmosphere maintained in our home is critical to the success of our child s spiritual and academic growth and development. We understand that if we cease to maintain a Christian lifestyle, that Dr. D.D. Brown Christian Academy of Hope reserves the right to terminate our enrollment. 4. We will cooperate fully in the educational functions of Dr. D.D. Brown Christian Academy of Hope, doing our best to make Christian Education effective in the lives of our children. 5. We will pay all our financial obligations to Dr. D.D. Brown Christian Academy of Hope on or before the date due. As the Lord enables, we will support the Academy with monetary gifts, as well as the gift of our time. We will volunteer as opportunities arise and as God provides time and strength. We will recommend Dr. D.D. Brown Christian Academy of Hope to others as opportunities arise. We will attend meetings and parents functions of the Academy regularly. If we become dissatisfied with the Academy in any respect, we will seek to resolve the matter with the person(s) involved rather than spread criticism or hold a negative attitude in our hearts. We will seek the advancement of Dr. D.D. Brown Christian Academy of Hope in all areas: spiritually, academically and financially. We acknowledge that discipline plays an important part in helping a child achieve academic excellence, spiritual growth and self-esteem. We agree to partner as a team with Dr. D.D. Brown Christian Academy of Hope. We recognize it is our privilege and responsibility to strive diligently toward observance of the above, as God enables us by the power of His Holy Spirit. Thank you. Your dedication plus Our Commitment to Excellence will guarantee your child s success in the school.
3. Warm Regards, Detach and return the lower signed portion to the school office Parent Agreement Pledge Signatures Child s Name Grade Signature (Father/Guardian) Date Signature (Mother/Guardian) Date STUDENT HEALTH APPRAISAL FORM Name: Address: Street City State Zip Birthdates: Male Female Month Date Year Does your child wear glasses? Yes/No Contacts? Yes/No Name of Child s Doctor: Address: Phone Number: Health Insurance Information: Name of Company Address Contact Number Policy/Member # Has your child ever had an allergic reaction to anything (eggs, peanut butter, bee stings, etc.)? If yes, please give the date and severity of the reaction. Has your child ever been on special medication? If yes, please give the medication and the reason for the medication. Is your child permanently taking regular medication? If yes, please give name of medication and reason for medication. Has your child ever had a serious injury we should be made aware of? If yes, please give details of the injury. Is there any other medical information not listed that Dr. D.D. Brown Christian Academy of Hope should be made aware of?
4. Place an X if child has problems with any of the following: Allergies Epilepsy/Seizures Asthma Hearing Speech Constipation/Diarrhea Frequent Colds Vision Fainting Behavior Problems Physical Handicap Breathing Please provide details: Parent Print Name Please Date Parent Signature Date STUDENT EMERGENCY CONTACT INFORMATION Name: Address: Street City State Zip Birthdates: Male Female Month Day Year Name and contact information of three (or more) adults we may call if you are not available: Name: Phone Relationship: Name: Phone Relationship: Name: Phone Relationship: Name: Phone Relationship: I do hereby authorize officials of Dr. D.D. Brown Christian Academy of Hope to contact directly the persons named on this card if the school cannot reach me. I authorize the named physician or his associates to render such treatment as may be deemed necessary in an emergency, for the health of the above mentioned child. In the event that parents or guardians, or other persons named on this card cannot be reached, Dr. D.D. Brown Christian Academy of Hope officials are hereby authorized to take whatever action is deemed necessary in the judgment for the health of the above mentioned child. I HAVE READ THIS FORM AND AGREE TO THE STATEMENT AS IT IS WRITTEN. Parent/Guardian Signature Date Parent/Guardian Signature Date STUDENT STANDARD OF CONDUCT
Dr. D.D. Brown Christian Academy of Hope (Dr. D.D. Brown Christian Academy of Hope) holds that the bible is the infallible, 5. divine word of God and that salvation by faith in Jesus Christ is the initial step in the Christian life. There is adequate Biblical basis for the idea of spiritual growth into the image of Jesus Christ (Romans 8:29), which is the work of the Holy Spirit (II Cor. 3:18). This growth begins with the initial act of saving faith and continues throughout life. The Holy Spirit makes the Christian conscious of the Biblical demands for the holy life that fulfills both God s moral law and high law of love (Matt. 22:37-40, Romans 13:8-10, Gal. 5:14). The result is a life consecrated unto God and separated from the world. Dr. D.D. Brown Christian Academy of Hope must, therefore, provide an environment conducive to the spiritual growth and development of young people who are not yet mature Christians. A standard of conduct based on the following Biblical imperatives is necessary to provide such an environment. All of the activities of the Christian must be subordinated to the glory of God who indwells us (I Cor. 8). The Christian will endeavor to avoid practices which cause the loss of sensitivity to the spiritual needs of the world and loss of the Christians physical, mental or spiritual well-being. (I Cor. 9:27). A sense of the need for spiritual growth in the light of these principles has led Dr. D.D. Brown Christian Academy of Hope to adopt the following standards which it is believed are conducive to the environment that will best promote the spiritual welfare of the students. The school, therefore, requests each student, whether at home, school, or elsewhere 1. To maintain Christian standards in courtesy, kindness, morality, and honesty. 2. To be dressed modestly and appropriately. 3. To refrain from swearing, indecent language, gambling, disorderly, boisterous behavior. 4. To refrain from the use, abuse or possession of drugs, tobacco products or alcoholic beverages. It is the school s belief that the sensual type dancing of today and the suggestive and explicit words of R&B and vulgar secular rap music does not promote the student s spiritual well-being, and therefore this type of music is not permitted on campus. Students are expected to abide by these standards while enrolled at Dr. D.D. Brown Christian Academy of Hope. Students found to be out of harmony with Dr. D.D. Brown Christian Academy of Hope s ideas of work and life may be invited to withdraw whenever the general welfare demands it, even though there may be no special breach of conduct. In the atmosphere of a conducive learning environment and positive Christian standards of conduct, there is great opportunity for developing a strong Christian character. I have read and explained the Student Standards of Conduct to my child/children he/she agreed to abide while enrolled at Dr. D.D. Brown Christian Academy of Hope. Detach and return the lower signed portion to the school office Student Standard of Conduct 6.
Student Signature/Name Date Signature (Father/Guardian) Date Signature (Mother/Guardian) Date STUDENT AUTHORIZED PICKUP INFORMATION Name: Address: Street City State Zip Relationship: Cell Phone: Home Phone: Name: Address: Street City State Zip Relationship: Cell Phone: Home Phone: Name: Address: Street City State Zip Relationship: Cell Phone: Home Phone: I do hereby authorize officials of Dr. D.D. Brown Christian Academy of Hope to release my child (ren) to any of the above mentioned persons named on this form. It is understood the persons listed above must provide identification before my child (ren) will be released in their care. In the event that if any of the persons named on this form cannot provide identification, Dr. D.D. Brown Christian Academy of Hope officials are hereby authorized to take whatever action is deemed necessary for the safety of the my child (ren), which may include, keeping the child (ren) at the academy until the parent and/or guardian is reached to pick up the child (ren). Late fees will be applied if child (ren) are not picked by the close of business. Please maintain a copy of this form for your records. I HAVE READ THIS FORM AND AGREE TO THE STATEMENT AS IT IS WRITTEN. Student Name Parent/Guardian Signature: Date: Parent/Guardian Signature: Date: Preschool provides an excellent early childhood education program that enables our students to develop intelligence, self-esteem and security in a learning environment. A learning environment that is fun and abundant with information that creates knowledge in each student. At Dr. D.D. Brown Christian Academy of Hope Private School our philosophy is focused on the intellectual development of each individual student by providing an environment that cultivates his own natural desire to learn. Our curriculum creates developmentally appropriate learning environments that empower children to become confident, successful, lifelong learners. Our curriculum incorporates the key elements that contribute
7. to a student s readiness for elementary school and academic success. NAME OF CONTACT PERSON: Pastor Mr. Errol Kat J. Washington Crowell-Grate TITLE/RELATIONSHIP TO NONPROFIT: Pastor Program of Kingdom Administration Christian for Outreach Greater Center. A.L.H. A.O.H. Church of God MAILING ADDRESS: PRIMARY TELEPHONE: ( ) ALTERNATE TELEPHONE: ( ) E-MAIL ADDRESS: NAME OF EDUCATION SERVICE PROVIDER (if any): NAME OF PARTNER ORGANIZATION (if any): Projected School Opening: Fall Spring School Year FEE SCHEDULE Registration & Comprehension Fees (due upon enrollment into Dr. D.D. Brown Christian Academy of Hope) Application fee: $35.00 Registration Fee: $125.00 Fee schedules for Dr. D.D. Brown Christian Academy of Hope. Tuition $6100.00 Contact school for tuition. Curriculum and Book fees $525.00 Fees for transportation $50.00 to Library Fees for Uniforms $200.00 Testing Fees $125.00
8. Other fees 50.00 Curriculum Fee: Please determine the grade level of your child for curriculum fee that is due. Curriculum fees are due upon enrollment into Dr. D.D. Brown Christian Academy of Hope.